BackgroundCannabidiol (CBD) is the non-euphoriant component of cannabis. In 2017, the New Zealand Misuse of Drugs Regulations (1977) were amended, allowing doctors to prescribe CBD. Therapeutic benefit and tolerability of CBD remains unclear.AimTo review the changes in self-reported quality of life measurements, drug tolerability, and dose-dependent relationships in patients prescribed CBD oil for various conditions at a single institution.Design & settingAn audit including all patients (n = 400) presenting to Cannabis Care, New Zealand, between 7 December 2017 and 7 December 2018 seeking CBD prescriptionsMethodIndications for CBD use were recorded at baseline. Outcomes included EuroQol quality of life measures at baseline and after 3 weeks of use, patient-reported satisfaction, incidence of side effects, and patient-titrated dosage levels of CBD.ResultsFour hundred patients were assessed for CBD and 397 received a prescription. Follow-up was completed on 253 patients (63.3%). Patients reported a mean increase of 13.6 points (P<0.001) on the EQ-VAS scale describing overall quality of health. Patients with non-cancer pain and mental-health symptoms achieved improvements to patient-reported pain and depression and anxiety symptoms (P<0.05). There were no major adverse effects. Positive side effects included improved sleep and appetite. No associations were found between CBD dose and patient-reported benefit.ConclusionThere may be analgesic and anxiolytic benefits of CBD in patients with non-cancer chronic pain and mental health conditions such as anxiety. CBD is well tolerated, making it safe to trial for non-cancer chronic pain, mental health, neurological, and cancer symptoms.
BackgroundIn 2017, revision of the Misuse of Drugs Act in New Zealand (NZ) allowed all medical practitioners to prescribe cannabidiol (CBD), a non-euphoriant constituent of cannabis. More information is needed on its therapeutic potential. This is an audit of all patients prescribed CBD from a single private clinic (Cannabis Care, Henderson, New Zealand) from 7th December 2017 to 3rd June 2020. We describe the patient population seeking CBD prescriptions in routine care in NZ, indications for use and quality of life (QOL) indices.MethodsPatient records were audited by the primary clinician, who had assessed indication for use and QOL indices (EuroQol-5D-5L and EQ-VAS). Indications were coded into four categories: non-cancer pain, emotional distress, neurological symptoms and cancer symptoms. Change in QOL and perceived patient efficacy was described where available. SAS version 9.4 was used. Data descriptions are by mean and standard deviation (SD). Categorical variables were described by counts and proportions expressed as percentages. Paired t-tests were used to compare V1 and V2 VAS scores. ResultsOf 1264 patient records reviewed the mean age was 51 years (SD 20.6), with 55.5% female. Non-cancer pain was the primary indication for use (49.4%). The mean EQ-VAS score at first visit in patients over 16 years (n=924) was 50 (SD 22.3) and 65 (n=384, SD 21.1) at follow up. The mean difference in VAS score in returning patients (n=332) was -11.1 (95% CI -13.2 to -9.0, p<.0001), indicating a positive change in health rating. ConclusionsIn NZ a range of patients are seeking CBD prescriptions, primarily for pain, with a sub-group reporting improved health following use. Further research into the clinical application of these products, especially dosage, precise indications and associated adverse events, is needed.
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